Dr Papadogeorgakis NDepartment of Oral and Maxillofacial Surgery, Dental School, University of Athens.rn

Although clinical and histological factors have helped in predicting survival in patients with oral squamous cell carcinoma, there has been need for more specialized diagnostic and prognostic factors. The research has focused on discovering biologic markers, as well as factors related to the morphology of the neoplastic cells and tissues, which can be studied through computer-aided image analysis. Image analysis methods are divided into two categories: conventional methods, which usually focus on the size of the nuclei and more modern and accurate methods, which produce, by means of fractal analysis, results that can be proved to be mathematically reliable. These methods assess the nuclear complexity and the complexity of other structures of the neoplastic tissue such as the vascular complexity. Image analysis methods and especially fractal analysis, confirm mathematically the pathologist’s subjective assessments. The aim of this article is to review fractal analysis applications in the study of oral cancer and to show its usefulness in diagnosis and prognosis. More specifically this study focuses on fractal dimensions, and especially nuclear fractal dimension (FD) and vascular fractal dimension (VFD), as prognostic factors in oral cancer.